Ruppy: Teaching old dogs new tricks

Getting disparate groups to work together can be a daunting challenge. Anyone who has
been through a practice merger can attest to this. But next time you are sitting in
a meeting and you hear someone say, “Our cultures are too different”
or “This is impossible; they have a different view of the universe,”
think about Ruppy.

The world's first transgenic dog, Ruppy (for “Ruby Puppy”) made his
debut alongside four of his fellow transgenic brothers and sisters in April 2009.
A team of scientists led by Byeong-Chun Lee of Seoul National University in South
Korea created the transgenic dogs through the use of retroviral integration to transfer
a fluorescent gene—normally expressed by sea anemones—into dog fibroblast
cell nuclei. The fibroblast cells' nuclei were then introduced into separate dog egg
cells, which had had their original nuclei removed. After the egg cells had divided,
the cloned embryo was implanted into a surrogate mother. The transferred gene codes
for a fluorescent protein that glows red under ultraviolet light when it is expressed.

Photo by AP Images

Scientists are interested in using the transgenic dogs as models to study human disease
and cancer pathogenesis. Transgenesis is a notoriously laborious and expensive method
of studying gene expression. The scientists began with 344 embryos, which they implanted
into 20 dogs; this resulted in only seven pregnancies. One of the fetuses died in
utero, while an 11-week-old puppy died due to complications from pneumonia. Five of
the puppies survived in utero and are alive and healthy, and will soon begin to give
birth to the next generation of fluorescent puppies.

Aside from the low efficiency of cloning (just 1.7% of the embryos came to term),
another common problem is controlling where the cloned gene inserts into the nuclear
DNA. The team of scientists responsible for the creation of the transgenic puppies
used a retrovirus to insert the gene into the canine nuclear DNA, but they were unable
to control where the virus inserted into the gene. Presumably, this would prevent
researchers from using the transgenic dog as a model to study the role of gene deletion
in cancer pathogenesis or using the dog model to study mutant forms of a gene. These
knockout procedures, also known as gene targeting, are commonly performed in mice
and rats.

Despite the limitations, the production of a transgenic dog model is considered to
be an important accomplishment in showing that cloning and transgenesis can be applied
to a wide range of mammals. Through the combination of a special fluorescent gene
and a puppy, we now have a model (albeit an imperfect one) to study cancer and other
pathological processes.

If two such different organisms can be combined to produce a working model for studying
disease mechanisms, why should effective interdisciplinary collaboration between nursing
staff and physicians be so difficult to achieve?

Research suggests that health care can be improved and patient harm reduced when health
professionals successfully collaborate across professional boundaries. A recent study
in the Journal of Interprofessional Care (Reeves et al., 2009) included more than 155 hours of observation and 47 interviews
from a variety of health professionals. The investigators found that interprofessional
interactions were “terse” and consisted of “unilateral comments
from physicians to other health professionals.”

In contrast, interactions between other health professionals were “richer and
lengthier” and comprised negotiations. The benefits of interdisciplinary collaboration
include improved job satisfaction for clinicians and higher quality of care for patients.

As with transgenesis, the process of achieving interprofessional collaboration is
not likely to be without complications. But by focusing our efforts on teamwork, communication,
and strong relationships, successful collaboration between clinicians and other providers
can be achieved. After all, if a chimera of a cnidarian and a canine can make a glow-in-the-dark
doggie, anything's possible.

Ms. Steckelberg is a medical student at the Mayo Clinic in Rochester, Minn. Dr. Newman
is a hospitalist at the Mayo Clinic, and editorial advisor to ACP Hospitalist.

ACP Hospitalist provides news and information for hospitalists, covering the major issues in the field. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated.